Service not separately priced by part B (e.g., services not covered, bundled, used by part a only, etc.)

HCPCS Multiple Pricing Indicator Code

9

Description

Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99')

HCPCS Coverage Code

D

Description

Special coverage instructions apply

HCPCS Processing Note Number

0133

HCPCS Berenson-Eggers Type Of Service Code

Y2

Description

Other - non-Medicare fee schedule

HCPCS Type Of Service Code #1

1

Description

Medical care

HCPCS Type Of Service Code #2

L

Description

ESRD supplies (eff 04/95) (renal supplier in the home before 04/95)

HCPCS Anesthesia Base Unit Quantity

0

HCPCS Code Added Date

20101001

HCPCS Action Effective Date

20101001

HCPCS Action Code

N

Description

No maintenance for this code

Detailed Information

Field Name

Field Value

Field Description

Healthcare Common Procedure Coding System Code

Q5010

The Healthcare Common Prodecure Coding System (HCPCS) is a
collection of codes that represent procedures, supplies,
products and services which may be provided to Medicare
beneficiaries and to individuals enrolled in private health
insurance programs. The codes are divided into two
levels, or groups, as described Below:
Level I
Codes and descriptors copyrighted by the American Medical
Association's current procedural terminology, fourth
edition (CPT-4). These are 5 position numeric codes
representing physician and nonphysician services.
**** NOTE: ****
CPT-4 codes including both long and short descriptions
shall be used in accordance with the CMS/AMA agreement.
Any other use violates the AMA copyright.
Level II
Includes codes and descriptors copyrighted by the
American Dental Association's current dental terminology,
seventh edition (CDT-2011/12). These are 5 position
alpha-numeric codes comprising the d series. All other
level II codes and descriptors are approved and
maintained jointly by the alpha-numeric editorial panel
(consisting of CMS, the Health Insurance Association of
America, and the Blue Cross and Blue Shield Association).
These are 5 position alpha- numeric codes representing
primarily items and nonphysician services that are not
represented in the level I codes.

HCPCS Long Description

Hospice home care provided in a hospice facility

Contains all text of procedure or modifier long descriptions.
As of 2013, this field contains the consumer friendly
descriptions for the AMA CPT codes. The AMA owns the
copyright on the CPT codes and descriptions; CPT codes
and descriptions are not public property and must always
be used in compliance with copyright law.

HCPCS Short Description

Hospice home care in hospice

Short descriptive text of procedure or modifier code
(28 characters or less).
The AMA owns the copyright on the CPT codes and
descriptions; CPT codes and descriptions are not
public property and must always be used in compliance
with copyright law.

Pricing Indicator Code #1

00

Code used to identify the appropriate methodology for
developing unique pricing amounts under part B. A procedure
may have one to four pricing codes.

Description

Service not separately priced by part B (e.g., services not covered, bundled, used by part a only, etc.)

Description of Pricing Indicator Code #1

HCPCS Multiple Pricing Indicator Code

9

Code used to identify instances where a procedure
could be priced under multiple methodologies.

Description

Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99')

HCPCS Multiple Pricing Indicator Code Description

HCPCS Coverage Code

D

A code denoting Medicare coverage status.

Description

Special coverage instructions apply

HCPCS Coverage Code Description

HCPCS Processing Note Number

0133

Number identifying the processing note contained in Appendix A of the HCPCS manual.

HCPCS Berenson-Eggers Type Of Service Code

Y2

This field is valid beginning with 2003 data.
The Berenson-Eggers Type of Service (BETOS) for the
procedure code based on generally agreed upon clinically
meaningful groupings of procedures and services.

Description

Other - non-Medicare fee schedule

HCPCS Berenson-Eggers Type Of Service Code Description

HCPCS Type Of Service Code #1

1

The carrier assigned CMS type of service which
describes the particular kind(s) of service
represented by the procedure code.

Description

Medical care

Description of HCPCS Type Of Service Code #1

HCPCS Type Of Service Code #2

L

The carrier assigned CMS type of service which
describes the particular kind(s) of service
represented by the procedure code.

Description

ESRD supplies (eff 04/95) (renal supplier in the home before 04/95)

Description of HCPCS Type Of Service Code #2

HCPCS Anesthesia Base Unit Quantity

0

The base unit represents the level of intensity for
anesthesia procedure services that reflects all
activities except time. These activities include
usual preoperative and post-operative visits, the
administration of fluids and/or blood incident to
anesthesia care, and monitering procedures.
(Note: the payment amount for anesthesia services
is based on a calculation using base unit, time
units, and the conversion factor.)

HCPCS Code Added Date

20101001

The year the HCPCS code was added to the Healthcare common procedure coding system.

HCPCS Action Effective Date

20101001

Effective date of action to a procedure or modifier code

HCPCS Action Code

N

A code denoting the change made to a procedure or modifier code within the HCPCS system.